Provider Demographics
NPI:1619443587
Name:HUTCHINGS, JACQUELYN (FNP)
Entity Type:Individual
Prefix:
First Name:JACQUELYN
Middle Name:
Last Name:HUTCHINGS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625 SE N ST APT 202D
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97526-4095
Mailing Address - Country:US
Mailing Address - Phone:541-941-2608
Mailing Address - Fax:
Practice Address - Street 1:1619 NW HAWTHORNE AVE STE 204
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-6009
Practice Address - Country:US
Practice Address - Phone:541-916-8530
Practice Address - Fax:541-916-8533
Is Sole Proprietor?:No
Enumeration Date:2018-10-18
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201809553NP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily